Videoconferencing psychotherapy from a psychodynamic point of view. A qualitative analysis.

There is a growing interest in delivering videoconferencing psychotherapy (VCP) due to the enormous impact of the COVID-19 pandemic on our lives since the beginning of severe restrictions worldwide in March 2020. Scientific literature has provided interesting results about the transition to remote sessions and its implications, considering different psychotherapy orientations. Less is known about whether and how VCP affects psychodynamic psychotherapeutic approaches and reports on remote work with severe and complex mental health problems such as severe personality disorders are still scarce.

Developments in Group Transference-Focused Psychotherapy.

Several evidence-based psychotherapies for personality disorders have been developed in recent decades, including transference-focused psychotherapy (TFP), a contemporary model of psychodynamic psychotherapy developed by Otto Kernberg. Kernberg established Group TFP (TFP-G) as an alternative or adjunct treatment to individual TFP. Although not yet manualized, TFP-G is used in publicly and privately funded mental health services, including outpatient clinics, subacute hospitals, therapeutic inpatient units, partial hospitalization services, and rehabilitation services serving people with borderline personality.

The Development of Transference-Focused Psychotherapy and Its Model of Supervision.

Transference-focused psychotherapy (TFP) is an empirically based, manualized psychodynamic psychotherapy that emerged as an adaptation of psychoanalytic techniques to meet the needs of patients with personality pathology. As it became more clearly defined through a series of treatment manuals and empirical research, TFP has also come to be considered a conceptual and technical model of therapy that can be used to introduce therapists in training to the principles of psychodynamic psychotherapy in a systematic way. Advanced levels of TFP training and practice involve an emphasis on supervision that is applied in a more structured way than traditional psychodynamic supervision, while respecting the depth and subtlety of psychoanalytic exploration.

Transference-Focused Psychotherapy for Pathological Narcissism and Narcissistic Personality Disorder (TFP-N).

In this article, we provide an overview of transference-focused psychotherapy for patients with pathological narcissism and narcissistic personality disorder (TFP-N). In TFP-N we have modified and refined the tactics and techniques of TFP, an evidence-based treatment for borderline personality disorder, to meet the specific challenges of working with patients with narcissistic personality pathology whose retreat from reality into an illusory grandiosity makes them particularly difficult to engage in treatment. We first describe a model of narcissistic pathology based on considerations of psychological structure stemming from object relations theory.

Functions of the Treatment Contract in TFP.

The use of a verbal or written contract has been employed in many different modalities of treatment as a means of establishing the expectations and parameters of treatment. Traditionally, the contract is seen as serving a somewhat utilitarian purpose: setting up the practical conditions of treatment and providing a containing frame for the patient. Contracts, however, can extend to establishing agreed-upon goals of treatment, anticipating obstacles that may arise in the treatment and clarifying how they will be dealt with should they arise, and clearly defining the roles of the patient and therapist in a way that aids the exploratory process once the treatment has begun.